Joseph Wolpe (April 20, 1915 – December 4, 1997) was a South African-born American psychologist, famous for his work on systematic desensitization and assertiveness training. His techniques used in treatment of phobias and anxiety provided the basis for modern behavior therapy. He developed the Subjective Units of Disturbance Scale (SUDS) for assessing the level of subjective discomfort or psychological pain.
While his ideas were initially criticized, particularly by psychoanalysts whose approach was dominant at the time, as treating only the symptoms and not the underlying causes, his treatment proved effective. Many have benefited from receiving therapy based on his ideas, facing their fears and overcoming them, with major improvement in the quality of their lives. Thus, Wolpe's work is considered a valuable contribution to reducing the suffering of many people and bringing all closer to the ideal of a happy and successful life.
Joseph Wolpe was born on April 20, 1915, in Johannesburg, South Africa, into the family of Michael Salmon and Sarah Millner Wolpe. He grew up in South Africa and received his education there. He obtained his M.D. from the University of Witwatersrand, Johannesburg.
When World War II broke out, Wolpe joined the South African army as a medical officer and worked in a military psychiatric hospital. There, he treated patients suffering from post-traumatic stress disorder (PTSD), then known as “war neurosis.” He first started to work on systematic desensitization during this time.
After the war, Wolpe worked at the University of Witwatersrand. There, he expanded on his technique of systematic desensitization and conducted a series of studies.
He married in 1948, to Stella Ettman, with whom he had two children. Wolpe immigrated with his family to the United States and started to teach at the University of Virginia in 1960. In 1965, he became a professor of psychiatry at Temple University Medical School in Philadelphia, a post that he held until his retirement in 1988. He was also director of the behavior therapy unit at the nearby Eastern Pennsylvania Psychiatric Institute. He served as the second president of the Association for the Advancement of Behavior Therapy.
Wolpe founded the Association for Advancement of Behavior Therapy and the Journal of Behavior Therapy and Experimental Psychiatry.
Wolpe retired from Temple in 1988, and moved to California. However, he continued to teach, lecturing at the Pepperdine University for an additional nine years. His first wife, Stella, died in 1990, and he remarried in 1996 to Eva Gyarmati.
Wolpe died of lung cancer on December 4, 1997.
During World War II, working as a medical officer in a military psychiatric hospital, Wolpe treated soldiers suffering from post-traumatic stress disorder, then known as "war neurosis.” As the standard treatment of drug therapy proved ineffective, Wolpe decided to find alternative methods of treatment. He developed a desensitization technique, a type of behavior therapy that used relaxation methods in dealing with fear and anxiety responses. The idea had some common elements with the relaxation techniques of Edmund Jacobson.
His systematic desensitization technique was grounded in the belief that much of human behavior is learned, and as such, could also be unlearned. Wolpe initially experimented with cats. He used Pavlovian classical conditioning, pairing an unpleasant shock with certain sounds to condition the cats to react with fear toward those sounds. Once the cats started to react with fear to the sounds presented alone, Wolpe would reverse the experiment and start to pair those sounds with a pleasant stimulus—food. After several sessions the cats would gradually unlearn their fear. Wolpe rationalized that similar techniques could be applied in treating phobias, and he developed a method of relaxation and gradual exposure to the unpleasant object until the phobia gradually disappeared.
In 1958, Wolpe published his Psychotherapy by Reciprocal Inhibition, in which he revealed his ideas. He claimed that it was possible to treat the symptoms of anxiety or phobias by teaching patients to relax and confront their fears. The book was met with skepticism and disdain by the psychiatric community. Being trained in the psychoanalytical tradition, they believed that Wolpe’s method did not tackle the “cause" of neuroses, but only the surface of it. They believed the therapy would inevitably lead to “symptom substitution” and not a cure. Wolpe’s therapy, however, proved successful and has continued to be used in modern psychotherapeutic treatment.
Wolpe developed a theory of learning called reciprocal inhibition. Reciprocal behaviors are behaviors that compete with each other. If one situation elicited a certain response, the new stimulus introduced could elicit a different response, and the old reaction could be weakened. As the subject increasingly reacts in an alternative way, new learning occurs and the old behavior gradually disappears completely.
Wolpe also worked on assertiveness training. The idea behind this is similar to systematic desensitization. People who are unassertive are similar to people with phobias, only the fear is of confrontation or rejection. These people unlearn their fears and gradually learn new behaviors. Wolpe taught them how to relax in a stressful situation and how to conquer their fears.
In 1969, Wolpe developed the Subjective Units of Disturbance Scale (SUDS) for assessing the level of subjective discomfort or psychological pain. It is a scale from 0 to 10 for measuring the subjective intensity of disturbance or distress currently being experienced, where 0 represents no disturbance, and 10 represents the worst disturbance the subject can imagine. The individual makes a self-assessment of where he is on the scale. The SUDS score is useful as a benchmark for a professional to evaluate the progress of treatment. The measure is taken at several intervals during the treatment of each upsetting memory or phobic situation, and treatment is generally continued until the SUDS reaches 0.
Assessment on the scale is entirely subjective. The basic guideline is that the individual assess herself based on their current experience. The scale is basically described as follows:
10 = Feels unbearably bad, out of control, as in a nervous breakdown, overwhelmed. The subject may feel so upset that he does not want to talk because he cannot imagine how anyone could possibly understand his agitation.
9 = Feeling desperate. What most people call a 10 is actually a 9. Feeling very, very bad, losing control of emotions, almost unbearable and are afraid of what she might do.
8 = The beginning of alienation, approaching loss of control.
7 = On the edge of some definitely bad feelings, maintains control with difficulty.
6 = Feeling bad to the point that subject begins to think something ought to be done about the way she feels.
5 = Moderately upset, uncomfortable. Unpleasant feelings are still manageable with some effort.
4 = Somewhat upset, to the point that the subject cannot easily ignore an unpleasant thought; feeling uncomfortable.
3 = Mildly upset, worried, bothered to the point that the subject notices it.
2 = A little bit upset, but not noticeable unless the subject pays attention to his feelings and then realizes there is something bothering him.
1 = No acute distress and feeling basically good, if the subject makes special effort she might feel something unpleasant, but not much.
0 = Peace, serenity, total relief, no bad feelings of any kind about any particular issue.
Wolpe was a pioneer of cognitive-behavior therapy. His techniques of systematic desensitization, designed for curing phobias and anxiety, as well as his methods used in assertiveness training provided the basis for modern behavior therapy. His Subjective Units of Disturbance Scale has been successfully used in numerous psychotherapeutic techniques, including Eye Movement Desensitization and Reprocessing (EMDR), Trauma-Focused Therapy (TFT), and Emotional Freedom Techniques (EFT).
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